慢性重型肝炎中医证候规律的回顾性研究中医内科学专业毕业论文.docx

次为肝胆热毒炽盛型、痰火扰神型、气滞血瘀型，脾肾阳虚型、气阴两 虚型的凝血酶原活动度最低。谷丙转氨酶水平，血清白蛋白水平在证型 的分布上，湿热内蕴型最高，其次为肝胆热毒炽盛型、痰火扰神型、气 滞血瘀型，脾肾阳虚型、气阴两虚型最低；总胆红素水平、谷草转氨酶 在证型的分布上则湿热内蕴型最低，其次为肝胆热毒炽盛型、痰火扰神 型、气滞血瘀型，脾肾阳虚型、气阴两虚型最高。MELD（终末期肝病模 型）评分及死亡率在证型的分布上，则湿热内蕴型最低，其次为肝胆热 毒炽盛型、痰火扰神型、气滞血瘀型，脾肾阳虚型、气阴两虚型最高。 并发症的发生率在证型的分布上，“邪实”证型患者并发症发生率低于 “正虚”证型（P0.05），“邪实”证型中又以湿热内蕴并发症发生率最 低，其次为肝胆热毒炽盛型及痰火扰神型，气滞血瘀型的并发症发生率 最高。“正虚”证型中则以气阴两虚的并发症发生率最高。 结 论： 慢性重型肝炎的中医证型分布在主要临床表现、中医舌象、 脉象、病程、病情、凝血功能指标、肝功能指标、MELD评分、死亡率、 并发症的发生率等指标上存在规律性。“邪实”证型患者较“正虚”证型 患者整体情况佳，预后好。“邪实”证型患者中以湿热内蕴型整体情况较 佳，预后较好，其次为肝胆热毒炽盛型、痰火扰神型，最后为气滞血瘀 型。“正虚”证型患者中以脾肾阳虚型整体情况较佳，预后较好。通过 总结该规律，可对各患者的预后进行综合判断，为慢性重型肝炎的中医 治疗提供理论依据。 关键词：慢性重型肝炎；中医辨证分型；MELD评分；回顾性研究 Chronic severe hepatitis law of TCM Syndrome The retrospective study Objective: To study and explore the chronic severe hepatitis syndrome differentiation and gender, clinical symptoms, tongue signs, pulse, course condition and liver function indicators, clotting function, MELD (model for end-stage liver disease) score, mortality, The incidence of complications between the inner contact to identify patients with chronic severe hepatitis TCM Syndrome rules of TCM to provide objectivity indicators, traditional Chinese and western medicine for the treatment of chronic severe hepatitis programs provide the basis for the formulation. Methods: We retrospectively investigate the use of research methods, from January 2005 to December 2008 in Guangxi College of Traditional Chinese Medicine First Affiliated Hospital of liver disease subjects diagnosed as chronic severe hepatitis cases to 106 cases of statistical analysis of the TCM Syndrome and sex, clinical symptoms, tongue, pulse, course condition and liver function indicators, clotting function, MELD (model for end-stage liver disease) score, mortality, incidence of complications between the inner contact. Results: The patients with chronic severe hepatitis on TCM syndrome distribution in order to damp intrinsic type, hepatobiliary drug flaming hot type, Fire God disturbance type,